Fathia Nkrumah was born and brought up in Zeitoun, a district of Cairo, to a Coptic Christian family. She was the third daughter of a civil servant who died early; Fathia was raised by her mother single-handedly after her husband's death.

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She was born Fathia Halim Ritzk in Zeitoun, Cairo, in 1932. Her father worked as a clerk in an Egyptian telephone company and died early, leaving her mother widowed and had to raise Fathia single-handed. She is the eldest of five children in the family.[3] After completing her secondary education, where she studied French.[4] she worked as a teacher at her school in Zeitoun, Notre Dame des Apôtres. As teaching did not appeal to her, she took a job in a bank. Frederick, an American journalist, who published her book in 1967, said Nkrumah sent his friend, Alhaji Saleh Said Sinare, who was one of the first Ghanaian Muslims to study in Egypt, to find him a Christian wife from Egypt, and Fathia was one of the final five women chosen.[4] At that stage, Kwame Nkrumah proposed to marry her. Her mother was reluctant to see another of her children marry a foreigner and quit the country, as Fathia's brother had left Egypt with his English wife. Fathia explained that Nkrumah was an anti-colonial hero, like Nasser, yet her mother refused to speak to her or bless the marriage. Nkrumah married Fathia at Christianborg Castle, Accra on the evening of the 1957 New Year's Eve upon her arrival in Ghana.[5]

Fathia Nkrumah was a very young wife and mother of three very young children when her husband was overthrown in Ghana's first successful military coup d'état on February 24, 1966.[6] She had to take her children to Cairo, Egypt, to be raised there while her husband went into exile.